Changes

=== ''Tattva Vimarsha'' ===

=== ''Tattva Vimarsha'' ===

*Hikka and shwasa originate at the site of pitta (upper part of stomach). The nature of disease is mainly kapha and vata dominant. The aggravation leads to depletion of dhatus like rasa situated in heart.

*''Hikka'' and ''shwasa'' originate at the site of ''pitta'' (upper part of stomach). The nature of disease is mainly ''kapha'' and ''vata'' dominant. The aggravation leads to depletion of ''dhatus'' like ''rasa'' situated in heart.

*The environmental pathogens like dust, pollens, smoke particles, improper diet and lifestyle regimen, and various other obstructions in channels carrying prana can cause the diseases.  

*The environmental pathogens like dust, pollen, smoke particles, improper diet and lifestyle regimen, and various other obstructions in channels carrying ''prana'' can cause the diseases.  

*Hikka and shwasa can originate secondary to various conditions like ama, anaha (constipation associated with flatulence), excess dryness in the body, excessive depletion (apatarpana), weakness, injury to marmas (vital points), frequent exposure to heat and cold, diarrhoea, fever, vomiting, rhinitis, kshata (injury), kshaya (wasting), raktapitta (bleeding disorder), udavarta (upward movement of vata), visuchika (enteritis), alasaka (sluggish bowel), pandu (anaemia) and intake of poisons. In this case, the treatment will focus on primary disease along with management of hikka and shwasa also.  

*''Hikka'' and ''shwasa'' can originate secondary to various conditions like ''ama, anaha'' (constipation associated with flatulence), excess dryness in the body, excessive depletion (''apatarpana''), weakness, injury to ''marmas'' (vital points), frequent exposure to heat and cold, diarrhea, fever, vomiting, rhinitis, ''kshata'' (injury), ''kshaya'' (wasting), ''raktapitta'' (bleeding disorder), ''udavarta'' (upward movement of ''vata''), ''visuchika'' (enteritis), ''alasaka'' (sluggish bowel), ''pandu'' (anemia) and intake of poisons. In this case, the treatment will focus on primary disease along with management of ''hikka'' and ''shwasa'' also.  

*Pranavaha srotasa (channels carrying prana) are mainly involved in the pathogenesis of hikka and shwasa.  

*''Pranavaha srotasa'' (channels carrying ''prana'') are mainly involved in the pathogenesis of ''hikka'' and ''shwasa''.  

*Vayu along with kapha blocks the channels carrying prana, udaka and anna and produces mahahikka.

*''Vayu'' along with ''kapha'' blocks the channels carrying ''prana, udaka'' and ''anna'' and produces ''mahahikka''.

*The protocol for management of shwasa includes: 1. Liquefying kapha by snehana( massage) with oil mixed with rock salt 2.  Channelizing and further liquefying it to get expelled out by swedana (sudation) 3. Intake of unctuous food for increasing quantity of kapha ( in order to make it convenient to get expelled out as seen in mucolyic drugs) and pacification of vata 4. Therapeutic emesis to expel out vitiated kapha dosha 5. Medicated smoking with durgs having hot potency to remove remaining kapha dosha

*The protocol for management of ''shwasa'' includes:  

*Anulomana (treating vata to move in normal direction) is the principle of management for obstructed vata in case of hikka and shwasa.

**Liquefying ''kapha'' by ''snehana''( massage) with oil mixed with rock salt  

*Shwasa associated with cough and hoarseness of voice should be treated with vamana (therapeutic emesis)  

**Channelizing and further liquefying it to get expelled out by ''swedana'' (sudation)  

*In Tamaka shwasa, virechana (therapeutic purgation) should be given with vata-kaphahara medicines.  

**Intake of unctuous food for increasing quantity of ''kapha'' (in order to make it convenient to get expelled out as seen in mucolyic drugs) and pacification of ''vata''.  

*It is always required to keep the path of vata, clean (respiratory tract) by frequent purification therapies and removing obstruction.

**Therapeutic emesis to expel out vitiated ''kapha dosha''

*Purification therapies like vamana and virechana shall be administered after assessing bala(strength) of patient.   

**Medicated smoking with drugs having hot potency to remove remaining ''kapha dosha''

*The food, drinks and drugs having kapha-vata alleviating properties, ushna (hot) potency and facilitating normal movement of vata (vatanulomana) should be given in the patient of hikka and shwasa.

*''Anulomana'' (treating ''vata'' to move in normal direction) is the principle of management for obstructed ''vata'' in case of ''hikka'' and ''shwasa''.

*Brimhana (nourishment therapy) administered in hikka and shwasa and its complications make them curable. The shamana treatment (palliative therapy) prevents the complications. Karshana (depletion therapy) makes hikka and shwasa incurable. Hence strong medicines and therapies leading to depletion of tissues should never be administered in hikka and shwasa patients.

*''Shwasa'' associated with cough and hoarseness of voice should be treated with ''vamana'' (therapeutic emesis)  

*In ''tamaka shwasa, virechana'' (therapeutic purgation) should be given with ''vata-kaphahara'' medicines.  

*It is always required to keep the path of ''vata'', clean (respiratory tract) by frequent purification therapies and removing obstruction.

*Purification therapies like ''vamana'' and ''virechana'' shall be administered after assessing ''bala''(strength)of patient.   

*The food, drinks and drugs having ''kapha-vata'' alleviating properties, ''ushna'' (hot) potency and facilitating normal movement of ''vata'' (''vatanulomana'') should be given in the patient of ''hikka'' and ''shwasa''.

*''Brimhana'' (nourishment therapy) administered in ''hikka'' and ''shwasa'' and its complications make them curable. The ''shamana'' treatment (palliative therapy) prevents the complications. ''Karshana'' (depletion therapy) makes ''hikka'' and ''shwasa'' incurable.  

 

Hence strong medicines and therapies leading to depletion of tissues should never be administered in ''hikka'' and ''shwasa'' patients.

=== ''Vidhi Vimarsha'' ===

=== ''Vidhi Vimarsha'' ===